A well woman gynecologic visit to the gynecologist is all about the woman—her body and her reproductive health. It is a valuable opportunity for a woman to take care of herself in large part by learning to minimize health risks and maintain a healthy lifestyle with guidance from her gynecologist. The three main goals of a well woman visit that focus on health promotion and disease prevention include the recording and reviewing of a woman’s health history, a physical exam, and the setting of healthy goals.
Many women don’t think they need to see their gynecologist if they don’t perceive a problem. Also, many women equate the gynecologic exam or visit with the PAP test, and if they don’t need a PAP test, they don’t think they have to come to the gynecologist. It’s important to know, however, that many health problems are often first discovered through an annual well woman gynecologic exam. Every woman should be aware that diseases such as breast cancer, cervical cancer, and ovarian cancer have few noticeable symptoms, and earlier detection improves chances of survival. A well woman gynecologic visit is important for women of all ages and stages of reproduction, particularly as they adapt to the next phase of their gynecologic life.
- A complete check-up focused on preventive care
- Screening tests to help identify diseases early when they are easier to treat
- Taking a thorough family history to search for indicators of a hereditary gynecologic cancer or other cancer syndromes
- Education and counseling to help the woman make informed decisions about her health and healthcare
The first major component of a well woman gynecologic exam is the comprehensive personal health history. The goal of obtaining a good personal health history is to identify personal health risks, order indicated preventive health screenings and tests, and to set healthy goals. Getting a good health history includes asking a woman about her gynecologic history, reproductive health based on her gynecologic life stage, including planning pregnancy and transitioning to menopause, sexual activity, and psychological health. It also includes questions about sexually-transmitted infections, use of birth control, diet, physical activity, and home life and relationships, including unhealthy relationships and abuse.
Then there’s the family health history, for which at least three generations of family should be examined in order to help identify familial signs of an inherited gynecologic cancer syndrome, like HBOC (Hereditary Breast and Ovarian Cancer Syndrome) and Lynch Syndrome, also known as HNPCC (Hereditary Non-Polyposis Colorectal Cancer Syndrome), which can be the cause of uterine cancer. If a hereditary cancer syndrome is suspected, the woman can be referred to a genetic counselor to determine if she should be genetically tested, or, if her personal or family history are compelling, genetic testing can be done on site in the office via a blood or urine sample.
The next component of the well woman gynecologic exam is a thorough physical examination. Contrary to the belief that a well woman gynecologic exam is merely a breast exam and Pap test, this exam also includes careful assessment of the abdomen, peripheral lymph nodes, and the entire pelvis, which is achieved by a bimanual exam not only via the vagina, but also via the rectum. Thus, the rectum and anus are also evaluated, and it gives opportunity to test stool for microscopic blood as a means of detecting possible anal, rectal, or colonic pathology.
Finally, it is during the well woman gynecologic visit when reproductive health screenings are performed and ordered. Guidelines are followed for PAP and HPV testing and mammography. It is the ideal time for patient education on timely screening because, as it was shown in a study published in the Journal of the American Medical Association in 2022, lack of personal health knowledge has been the most common reason why women have significantly fallen behind in their cervical cancer screening (PAP and HPV testing) in the past 14 years.
Preparing for a well woman gynecologic visit helps a woman get the most out of it. Being prepared with knowledge of one’s family health history, knowing details about one’s own medical history, and having questions ready about sex and sexually-transmitted infections, about how to prepare to become pregnant, about perimenopause and menopause, birth control, and any other health concerns is very important.
We at Adaptive Gynecology establish a trusting and enduring relationship with the women in our practice, based on open and frank dialogue combined with exceptional clinical care. In this way, a woman can confidently take an active role in her health care and optimize her health and quality of life.
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